The Reasoning GP Podcast

Hypertension: treating the number that causes no symptoms

Tue, 03 Nov 2026 07:00:00 +0000

A 52-year-old with a clinic reading of 162 over 98 and no symptoms at all. When do you act today, how do you confirm it, and which tablet first?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Hypertension protocol · Raised blood pressure pathway · QRISK3 calculator

Sources: NICE NG136 (last updated Feb 2026) · NICE NG133 · NICE NG12. Reviewed Oct 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Chronic heart failure: four pillars and a set of bathroom scales

Tue, 03 Nov 2026 06:59:00 +0000

A 74-year-old with swollen ankles who now stops twice on the way to the shops. What sets the echo clock, and why does every patient with a reduced ejection fraction need four tablets, not one?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Heart failure protocol · Breathlessness pathway · Ankle swelling pathway

Sources: NICE NG106 (Sept 2025) · ESC 2023 (international). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Atrial fibrillation: two questions, asked in parallel, for ever

Tue, 03 Nov 2026 06:58:00 +0000

A 68-year-old with an irregular pulse found at her flu jab, feeling a little tired but otherwise fine. How do you prevent the stroke, and how do you make her feel better?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Atrial fibrillation protocol · Palpitations pathway · CHA2DS2-VASc and other calculators

Sources: NICE NG196 · ESC 2024 (international). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Stable angina: two tracks, one spray, and a five-minute rule

Tue, 03 Nov 2026 06:57:00 +0000

A 61-year-old builder gets a tight chest carrying bricks up a ladder that settles when he stops. Is it stable, how do you prove it, and what keeps him out of the coronary care unit?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Stable angina protocol · Chest pain pathway · Lipid protocol

Sources: NICE CG95 (2010, updated 2016) · NICE CG126 (2011, updated 2016) · NICE NG238 (2023) · MHRA Drug Safety Updates · DVLA Assessing fitness to drive. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Lipids and CVD prevention: frame the patient before you pick the dose

Tue, 03 Nov 2026 06:56:00 +0000

A 49-year-old with a total cholesterol of 8.1 and a father who had a heart attack at 52. Do you reach for QRISK, or is this a different conversation?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Hypercholesterolaemia protocol · Familial hypercholesterolaemia protocol · QRISK3 calculator

Sources: NICE NG238 (2023). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Deep vein thrombosis: the dangerous symptom is in the chest

Tue, 03 Nov 2026 06:55:00 +0000

A 38-year-old on the combined pill, home from a long-haul flight, with a swollen, aching left calf. How fast do you need a scan, and what do you tell her before she leaves?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Deep vein thrombosis protocol · Unilateral leg swelling pathway · Pulmonary embolism protocol

Sources: NICE NG158 (2020, updated August 2023) · NICE NG12 (updated April 2026) · MHRA Drug Safety Update (June 2019): DOACs in APS · Local DOAC guidelines (February 2026) · RCOG Green-top 37b (pregnancy). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Peripheral arterial disease: a leg problem that is really a heart problem

Tue, 03 Nov 2026 06:54:00 +0000

A 66-year-old smoker whose calf cramps after 200 metres and eases when he stands still. How do you protect the limb, and why is this really about his heart and brain?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Peripheral arterial disease protocol · Claudication pathway · Smoking cessation protocol

Sources: NICE CG147 (2012, updated 2020) · NICE NG19 (2015, updated 2019) · NICE NG238 (2023) · NICE TA210 (2010) · NICE TA223 (2011) · NICE TA607 (2019) · NICE NG136 (2019, updated 2026) · NICE NG156 (2020) · NICE NG209 (2021, updated 2025) · VSGBI PAD-QIF (2019, updated 2022). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Palpitations: tap it out, then catch it on a recording

Tue, 03 Nov 2026 06:53:00 +0000

A 29-year-old teacher with episodes of a racing heartbeat that start and stop suddenly. Which features need a same-day ECG, and how do you catch a rhythm that has already gone?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Palpitations pathway · ECG interpretation guide · Atrial fibrillation protocol

Sources: NICE CG109 · NICE NG196 · ESC 2019 SVT guideline (international). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

After a heart attack: started is not the same as treated

Tue, 03 Nov 2026 06:52:00 +0000

A 57-year-old, three weeks after a stent for a heart attack, on five new tablets at starter doses. What does the first GP review need to achieve?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Post-MI secondary prevention protocol · Lipid protocol · DVLA guide

Sources: NICE NG185 (2020) · NICE NG238 (2023). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Asthma: every reliever puff should carry a steroid

Tue, 03 Nov 2026 06:51:00 +0000

A 24-year-old who has collected eight blue inhalers this year and is waking at night with a tight chest. Why is that a warning sign, and what does the 2024 guideline put in her hand instead?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Asthma protocol · Acute asthma pathway · Chronic cough pathway

Sources: NICE NG245 (2024, joint with BTS and SIGN) · BTS/SIGN 158 (2019; acute-attack sections retained after NG245) for the acute attack. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

COPD: the two treatments that change the story are not inhalers

Tue, 03 Nov 2026 06:50:00 +0000

A 63-year-old ex-builder, still smoking, breathless on one flight of stairs and coughing up phlegm every morning. How do you confirm it, and what actually slows it down?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: COPD protocol · Acute COPD pathway · Smoking cessation protocol

Sources: NICE NG115 · NG114. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Community-acquired pneumonia: severity is the diagnosis

Tue, 03 Nov 2026 06:49:00 +0000

A 71-year-old with three days of fever, a productive cough and crackles at the right base. Home with amoxicillin, or hospital? The answer starts with a full set of observations.

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Chest infections protocol · Acute cough pathway · Sepsis in adults protocol

Sources: NICE NG250 · NG120 · NG253 · NG115 · NG114 · NG12 · Local antimicrobial guidance. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Allergic rhinitis: the spray works if you aim it properly

Tue, 03 Nov 2026 06:48:00 +0000

A 17-year-old sitting exams in June, sneezing and sleepless, who says the steroid spray does nothing. Is it the drug, or the way she uses it?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Allergic rhinitis protocol · Nasal congestion pathway · Asthma protocol

Sources: BSACI rhinitis guideline (Scadding et al 2017) · BSACI immunotherapy guideline (Walker et al 2011) · ARIA-EAACI 2024–2025 (international) · MHRA Drug Safety Update (September 2019; April 2024) · NICE NG245 (2024). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Cough: the clock, the X-ray and one trial at a time

Tue, 03 Nov 2026 06:47:00 +0000

A 58-year-old ex-smoker whose cough has lasted ten weeks since a cold, now with some tiredness. When is a cough just post-viral, and when does it need a chest X-ray today?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Chronic cough pathway · Acute cough pathway · Haemoptysis pathway · Suspected cancer referrals

Sources: NICE NG12 (updated April 2026) · NICE NG120 · BTS clinical statement on chronic cough (2023). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Bronchiectasis: airway clearance every day, sputum before antibiotics

Tue, 03 Nov 2026 06:46:00 +0000

A 54-year-old who coughs up a cupful of phlegm every day and has had five chest infections this year. What confirms it, and what is the most important treatment?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Bronchiectasis protocol · Chronic cough pathway · Haemoptysis pathway

Sources: BTS guideline for bronchiectasis in adults (2019) · NICE NG117 (2018). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Smoking cessation: thirty seconds that change a life

Tue, 03 Nov 2026 06:45:00 +0000

A 45-year-old on clozapine who wants to stop smoking after three failed attempts. What do you offer, and which blood level must you not forget?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Smoking cessation protocol · COPD protocol · SMI physical health check

Sources: NICE NG209 (2021, updated Feb 2025) · NICE QS207 (Dec 2022) · MHRA Drug Safety Update (Aug 2020) · SPCs · NCSCT. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Type 2 diabetes: two tablets from day one

Tue, 03 Nov 2026 06:44:00 +0000

A 58-year-old with an HbA1c of 61 on routine bloods and no symptoms. Is it really type 2, what has changed in the 2026 first-line, and how do you protect the heart and kidneys as hard as you lower the sugar?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Type 2 diabetes protocol · Type 2 diabetes pathway · Sick day rules · QRISK3 calculator

Sources: NICE NG28 (Feb 2026). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Type 1 diabetes: never stop the basal insulin

Tue, 03 Nov 2026 06:43:00 +0000

A 34-year-old with three weeks of thirst, weight loss and a glucose of 19, labelled type 2 because he is a little overweight. What should make you think type 1, and what must every patient know about sick days?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Type 1 diabetes protocol · Diabetic ketoacidosis protocol · Unwell with diabetes on insulin · Driving and medical conditions

Sources: NICE NG17 (2015, updated 2022; Levemir note February 2026) · NICE NG238 (2023) · NICE TA151 (2008) · NICE TA943 (2023) · DVLA · JBDS · ABCD/PCDOS Levemir guidance (2025, updated 2026). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Hypothyroidism: read the pattern before you reach for the tablet

Tue, 03 Nov 2026 06:42:00 +0000

A 47-year-old who is tired, cold and constipated, with a TSH of 14 and a low free T4. What dose do you start, when do you recheck, and when is a raised TSH not something to treat at all?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Hypothyroidism protocol · Abnormal thyroid function pathway · Subclinical hypothyroidism pathway · Thyroid disease in pregnancy

Sources: NICE NG145 · BTA. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Hyperthyroidism: the sore throat that could kill

Tue, 03 Nov 2026 06:41:00 +0000

A 29-year-old with palpitations, weight loss, a tremor and a suppressed TSH. What do you start while she waits for endocrinology, and which one sentence must she hear before any carbimazole?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Hyperthyroidism protocol · Hyperthyroidism pathway · Thyroid nodule protocol · Thyroid disease in pregnancy

Sources: NICE NG145 (2019, updated Oct 2023) · MHRA Drug Safety Update (Feb 2019) · NICE NG12 (updated April 2026). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Obesity: a chronic disease, not a willpower test

Tue, 03 Nov 2026 06:40:00 +0000

A 44-year-old asks about weight-loss injections. Her body mass index is 33, she is of Pakistani family origin and has snored for years. How do you raise it well, what counts as success, and who gets drugs or surgery?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Obesity protocol · Weight gain pathway · Obstructive sleep apnoea protocol · BMI and risk calculators

Sources: NICE NG246 (2025) · NICE TA875 (2023) · NICE TA1026 (2024) · NHS England tirzepatide interim commissioning guidance (2025) · Local incretin therapy guidance (2026). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Addison's disease: treat the crisis before you confirm it

Tue, 03 Nov 2026 06:39:00 +0000

A 38-year-old with months of fatigue, weight loss, dizziness on standing and a sodium of 128, labelled as stress. What should make you think adrenal failure, and what turns a sick day into a crisis?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Addison's disease protocol · Addison's disease pathway · Sick day rules · Hyponatraemia pathway

Sources: NICE NG243 · Society for Endocrinology. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

B12 and folate deficiency: always B12 first

Tue, 03 Nov 2026 06:38:00 +0000

A 61-year-old on metformin with tingling feet, a large red cell size and low B12 and folate. Which do you replace first, by which route, and when is a normal blood count no reassurance at all?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Vitamin B12 deficiency pathway · Low folate pathway · Macrocytosis pathway · Coeliac disease protocol

Sources: NICE NG239 (2024) · BSH (2014). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Vitamin D deficiency: check the calcium before you load

Tue, 03 Nov 2026 06:37:00 +0000

A 52-year-old housebound woman with aching bones, weak thighs and a vitamin D of 18. Who should be tested at all, how do you load safely, and what high calcium must you not miss?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Vitamin D deficiency pathway · Hyperparathyroidism protocol · Hypercalcaemia pathway · Osteoporosis protocol

Sources: Royal Osteoporosis Society (2018, updated 2020) · SACN (2016) · NICE NG247 (2025). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Dyspepsia and reflux: never answer dysphagia with a stronger acid tablet

Tue, 03 Nov 2026 06:36:00 +0000

A 49-year-old with months of heartburn after late takeaways, now on ibuprofen for his back. When does reflux need a cancer pathway referral, how do you time the tablet, and how do you plan to stop it on day one?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Reflux disease protocol · Dyspepsia pathway · PPI prescribing protocol · Suspected cancer referrals

Sources: NICE CG184 · NG12 (updated April 2026). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Coeliac disease: test on gluten, or not at all

Tue, 03 Nov 2026 06:35:00 +0000

A 31-year-old with bloating, tiredness and iron deficiency who has already cut out bread to see if it helps. Why might her blood test now mislead you, and what does coeliac disease add that is easy to forget?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Coeliac disease protocol · Iron deficiency anaemia protocol · Chronic diarrhoea pathway · Immunisation schedule

Sources: NICE NG20 · UKHSA Green Book. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Irritable bowel syndrome: a positive diagnosis, not a shrug

Tue, 03 Nov 2026 06:34:00 +0000

A 27-year-old with a year of cramping pain eased by opening her bowels, bloating and loose stools on work days. Which tests do you need, which red flags change the plan, and why might the laxative make things worse?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Irritable bowel syndrome protocol · Bloating pathway · Chronic diarrhoea pathway · Coeliac disease protocol

Sources: NICE CG61 (2008, updated 2017) · NICE DG11 (now HTG320) · NICE NG12 (updated April 2026) · NICE HTG690 (2023, formerly DG56) · BSG IBS guideline 2021. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Constipation in adults: check the drug list before the laxative

Tue, 03 Nov 2026 06:33:00 +0000

A 72-year-old on codeine and amlodipine says she has been constipated for two months, which is new for her. What must you rule out first, and how do you climb the laxative ladder without making things worse?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Adult constipation protocol · Constipation pathway · Suspected cancer referrals · Opioid prescribing protocol

Sources: BDA 2025 · NICE NG12 · NICE HTG690 (FIT) · NICE TA345 / TA651 / TA211 · Local formulary. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Rectal bleeding: never just blame the piles

Tue, 03 Nov 2026 06:32:00 +0000

A 56-year-old with six weeks of bright red blood on the paper and a known pile. When does FIT decide the referral, when do you refer without waiting for it, and how do you safety-net the low result?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Rectal bleeding pathway · Suspected cancer referrals · Haemorrhoids protocol · Screening programmes

Sources: NICE NG12 (updated April 2026) · NICE HTG690 (FIT; formerly DG56) · BSG 2021 · ACPGBI/BSG FIT guidance 2025. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Gallstones: colic, or something that cannot go home

Tue, 03 Nov 2026 06:31:00 +0000

A 43-year-old with two hours of severe pain under the right ribs after a takeaway, now settling. How do you separate simple biliary colic from cholecystitis, cholangitis and pancreatitis, and what does jaundice change?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Cholecystitis and gallstones protocol · Biliary colic pathway · Jaundice pathway · Abnormal liver tests pathway

Sources: NICE CG188 (2014) · NICE NG12 (updated April 2026) · BSG 2017 (bile duct stones) · UK Working Party 2005 (pancreatitis, historical) · local acute pancreatitis pathway · SPCs · Local formulary. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Iron deficiency anaemia: a finding, never a diagnosis

Tue, 03 Nov 2026 06:30:00 +0000

A 67-year-old man, tired and breathless on the stairs, with a haemoglobin of 98 and a ferritin of 6. Iron tablets alone are not the answer. Where is the iron going, and how fast do you need to find out?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Iron deficiency anaemia protocol · Iron deficiency pathway · Coeliac disease protocol · Suspected cancer referrals

Sources: BSG 2021 (Snook et al., Gut) · ACPGBI/BSG FIT in IDA 2025 · BSH 2022 · NICE NG12 (updated April 2026) · NICE HTG690 · NICE NG24. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Haemorrhoids: examine before you reassure

Tue, 03 Nov 2026 06:29:00 +0000

A 34-year-old, four months after giving birth, with bright red blood on the paper and an itchy lump that pops out when she strains. How do you treat piles well, and what must you never assume?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Haemorrhoids protocol · Rectal bleeding pathway · Anal lumps pathway · Anal fissure protocol

Sources: NICE NG12 · NICE HTG690 (FIT) · Local formulary. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Chronic kidney disease: the urine test that changes everything

Tue, 03 Nov 2026 06:28:00 +0000

A 64-year-old with type 2 diabetes has an eGFR of 49 for the second time and an albumin-to-creatinine ratio of 38. Is this chronic kidney disease, who needs the kidney team, and which four drugs protect her?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: CKD protocol · CKD pathway · Sick day rules

Sources: NICE NG203 (2021) · KDIGO 2024 · NICE TA1075 (2025). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Acute kidney injury: find the cause, check the potassium, fix the drug list

Tue, 03 Nov 2026 06:27:00 +0000

A 78-year-old on ramipril, furosemide and over-the-counter ibuprofen has had two days of diarrhoea, and his creatinine has jumped from 95 to 150. Home or hospital, and what do you stop?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: AKI protocol · Raised creatinine and AKI pathway · Sick day rules

Sources: NICE NG148 · KDIGO 2012 · UK Kidney Association hyperkalaemia guideline (2023). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Urinary tract infection: when the dipstick helps, and when it lies

Tue, 03 Nov 2026 06:26:00 +0000

A 32-year-old with two days of burning and frequency, and an 84-year-old care home resident who is a bit more muddled with a positive dipstick. Same test, very different answers.

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: UTI in women protocol · UTI in men protocol · Recurrent UTI protocol · Dysuria pathway

Sources: NICE NG109 (2018, updated May 2025) · NICE NG111 (2018, updated 2024) · NICE NG112 (2018, updated Dec 2024) · UKHSA UTI diagnostic tools (updated July 2025) · MHRA Drug Safety Update (Sep 2014, Apr 2023, Jan 2024) · NICE NG12 (updated April 2026) · Local antimicrobial guidelines. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Haematuria: one episode of blood is enough

Tue, 03 Nov 2026 06:25:00 +0000

A 67-year-old ex-smoker on apixaban saw blood in his urine once last week, and now it is clear. Does the anticoagulant explain it, and which pathway does he need?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Haematuria pathway · Suspected cancer referrals · CKD protocol

Sources: NICE NG12 (updated April 2026) · NICE NG203 (2021) · BAUS and Renal Association haematuria consensus (2008). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Lower urinary tract symptoms in men: voiding or storage, and why it matters

Tue, 03 Nov 2026 06:24:00 +0000

A 69-year-old gets up three times a night and his stream is weaker than it was. Is it the prostate, is it the bladder, and when should you worry about cancer?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Male LUTS protocol · Benign prostate enlargement protocol · LUTS in men pathway · Raised PSA pathway

Sources: NICE CG97 (2010, updated 2015) · NG12 (updated April 2026) · TA290 (2013) · MHRA Drug Safety Updates · MHRA SPCs · Local formulary. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Renal colic: the patient who cannot keep still

Tue, 03 Nov 2026 06:23:00 +0000

A 38-year-old is pacing the room with loin pain running into his groin and has vomited twice. What must you exclude before calling it a stone, and what is the best painkiller?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Renal colic pathway · AKI protocol · Haematuria pathway

Sources: NICE NG118 (2019) · NICE QS195 · EAU Urolithiasis guideline (2024, international) · BAUS (2023). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Erectile dysfunction: a window onto the arteries

Tue, 03 Nov 2026 06:22:00 +0000

A 54-year-old smoker mentions, at the end of a consultation about his cough, that erections have been a problem for six months. What else is this telling you, and how do you make the tablets work?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Erectile dysfunction protocol · Erectile dysfunction pathway · Testosterone deficiency protocol · QRISK3 calculator

Sources: EAU Sexual and Reproductive Health (2026 limited update; 2023 ED recommendations) · BSSM · Princeton III (2012, international) · NICE NG12 (updated April 2026) · NHS Drug Tariff · Local formulary. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Hyperkalaemia: the blood result that cannot wait in the inbox

Tue, 03 Nov 2026 06:21:00 +0000

A 71-year-old with heart failure and kidney disease, on ramipril and spironolactone, has a routine potassium of 6.1. Repeat it, admit her, or stop everything?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Hyperkalaemia pathway · CKD protocol · AKI protocol

Sources: UK Kidney Association acute hyperkalaemia guideline (Dec 2023) · NICE NG203 (2021) · NICE TA1148 (2026) · NICE TA623. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Low back pain and sciatica: keep moving, and never forget the saddle

Tue, 03 Nov 2026 06:20:00 +0000

A 42-year-old warehouse worker hurt his back lifting and now has pain shooting down to his calf. He wants a scan and strong painkillers. What does he actually need?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Sciatica protocol · Back pain pathway · Cauda equina protocol

Sources: NICE NG59 (2016, updated July 2026) · NICE NG12 (updated April 2026). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Osteoarthritis: exercise is the treatment, not the warm-up

Tue, 03 Nov 2026 06:19:00 +0000

A 63-year-old with an aching knee wants an X-ray and has been told it is just wear and tear. How do you diagnose it without imaging, and what actually helps?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Osteoarthritis protocol · Knee pain pathway · Joint pain pathway

Sources: NICE NG226 (2022) · NICE QS87 (updated Oct 2022) · MHRA Drug Safety Update (Jun 2013, Jun 2015, Sep 2020) · product SPCs and local formulary · NICE NG12 (updated April 2026). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Gout: treat the flare, then treat to target

Tue, 03 Nov 2026 06:18:00 +0000

A 58-year-old on bendroflumethiazide woke with a red-hot big toe he cannot bear the sheet on. How do you settle tonight's attack, and how do you stop the next five?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Gout protocol · Gout pathway · Joint pain pathway

Sources: NICE NG219 (2022). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Rheumatoid arthritis: the window you must not let close

Tue, 03 Nov 2026 06:17:00 +0000

A 41-year-old has had swollen, painful knuckles and two hours of morning stiffness for eight weeks. Her rheumatoid factor is negative. Do you wait, or refer today?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Rheumatoid arthritis protocol · Joint pain pathway · Shared care monitoring

Sources: NICE NG100 (2018, updated 2020) · NICE QS33 (2013, updated 2020) · BSR csDMARD guideline 2025 · BSR pregnancy and breastfeeding guideline 2022 · MHRA DSU Sept 2020 and Apr 2023 · UKHSA Green Book ch.6, ch.25, ch.28a · NICE NG238 (2023) · NOGG 2024 · RCOphth 2020. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Polymyalgia rheumatica: bloods before the first tablet, and always ask about the head

Tue, 03 Nov 2026 06:16:00 +0000

A 72-year-old cannot get out of a chair in the mornings, both shoulders and hips ache, and her CRP is 45. What must you check before starting steroids, and what must you never miss?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Polymyalgia rheumatica protocol · Giant cell arteritis protocol · Raised CRP and ESR pathway · Osteoporosis protocol

Sources: BSR PMR guideline 2026 · BSR GCA guideline 2020 · NICE NG12 (updated April 2026) · NOGG 2024 · NICE NG243 (2024). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Shoulder pain: let passive movement tell you the diagnosis

Tue, 03 Nov 2026 06:15:00 +0000

A 56-year-old with type 2 diabetes has three months of shoulder pain and cannot reach behind his back. Cuff, capsule or something worse, and what will help him?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Shoulder pain pathway · Neck pain pathway · Polymyalgia rheumatica protocol

Sources: NICE NG12 (updated April 2026) · NICE NG226 (2022) · NICE NG127 · BESS and BOA shoulder pathways · local MSK and injection guidance. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Osteoporosis: every fragility fracture is a treatment opportunity

Tue, 03 Nov 2026 06:14:00 +0000

A 68-year-old slipped on her kitchen floor and broke her wrist. The fracture clinic has discharged her. Whose job is the next fracture, and what should happen now?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Osteoporosis protocol · Osteoporosis pathway · Falls pathway

Sources: NOGG 2024 · NICE NG259 (July 2026; replaced CG146) · TA464 (2017). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Plantar heel pain: the first steps of the morning tell the story

Tue, 03 Nov 2026 06:13:00 +0000

A 47-year-old nurse limps for the first few steps every morning with a sharp pain under her heel. She wants an injection. What works, how long will it take, and what else could it be?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Plantar fasciitis protocol · Foot pain pathway · Achilles tendinopathy protocol

Sources: JOSPT/APTA heel pain CPG (2023) · NICE HTG200/IPG311 (shockwave therapy, 2009) · NICE HTG298 (injection procedures) · local formulary. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Headache and migraine: the painkiller that keeps the headache going

Tue, 03 Nov 2026 06:12:00 +0000

A 34-year-old teacher has headaches most days and takes co-codamol nearly every day to get through work. Is this migraine, something sinister, or the tablets themselves?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Migraine protocol · Headache pathway · Medication-overuse headache protocol · Cluster headache protocol

Sources: NICE CG150 (updated June 2025) · BASH · TA919 · TA906 · TA973 · TA682 · TA764 · TA659 · TA871 · TA260 · UKMEC · MHRA · Local headache pathway. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Stroke and TIA: the warning that resolved by itself

Tue, 03 Nov 2026 06:11:00 +0000

A 68-year-old had twenty minutes of right arm weakness and slurred speech yesterday, and now feels completely back to normal. What happens in the next hour, and the next 24?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: TIA and stroke protocol · Antiplatelets and anticoagulants · DVLA guide

Sources: NICE NG128 (2019) · NICE TA210 (2010) · NICE NG236 (2023) · National Clinical Guideline for Stroke (2023) · NICE NG196 (2021) · NICE NG238 (2023) · NICE NG12 (updated April 2026) · DVLA. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Epilepsy and first seizure: the eyewitness is your best test

Tue, 03 Nov 2026 06:10:00 +0000

A 24-year-old was found on the bathroom floor, confused, having bitten her tongue. Was it a faint or a fit, and what must she be told before she leaves the room?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Epilepsy protocol · Transient loss of consciousness pathway · Fits and funny turns pathway · DVLA guide

Sources: NICE NG217 (2022, updated January 2025) · DVLA Assessing fitness to drive · MHRA valproate safety measures (2018, updated 2024) · MHRA topiramate Pregnancy Prevention Programme (2024) · CoSRH drug interactions with hormonal contraception · GMC confidentiality guidance · local shared-care protocols. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Parkinson's disease: on time, every time

Tue, 03 Nov 2026 06:09:00 +0000

A 71-year-old with a one-sided tremor has become slower, and his wife says he shouts in his sleep. Who makes the diagnosis, and which common prescription could make him much worse?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Parkinson's disease protocol · Tremor pathway · Falls pathway

Sources: NICE NG71 (2017) · MHRA Drug Safety Update (August 2013; May 2014; apomorphine with domperidone) · SPS swallowing guidance · DVLA. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Bell's palsy: look at the forehead, then protect the eye

Tue, 03 Nov 2026 06:08:00 +0000

A 39-year-old woke up unable to close her right eye, and her smile has dropped on one side. Is it a stroke, is it Bell's palsy, and what must start today?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Bell's palsy protocol · TIA and stroke protocol · Shingles protocol

Sources: NICE NG127 (2019) · Cochrane antivirals review (Gagyor 2019) · Local formulary · local Ramsay Hunt pathway · House–Brackmann (optional). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Dizziness and vertigo: timing and triggers tell the story

Tue, 03 Nov 2026 06:07:00 +0000

A 62-year-old has woken with the room spinning, and it has not stopped for a day. Is this an inner ear problem, or a stroke in disguise?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Vertigo pathway · BPPV protocol · Vestibular neuronitis protocol · Menière's disease protocol

Sources: NICE NG127 (2019) · NICE NG98 (2018) · NICE NG252 · Bárány Society criteria · DVLA. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Peripheral neuropathy: find the cause before you treat the pain

Tue, 03 Nov 2026 06:06:00 +0000

A 58-year-old with diabetes has burning feet that keep him awake. Which tests find a treatable cause, and when is tingling an emergency?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Sensory neuropathy pathway · Neuropathic pain protocol · Vitamin B12 deficiency pathway

Sources: NICE CG173 (2013, updated 2020) · NICE NG19 · NICE NG28 · NICE NG12 (updated April 2026). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Depression: ask about suicide, then ask about mania

Tue, 03 Nov 2026 06:05:00 +0000

A 23-year-old student says she has felt flat and hopeless for two months and wants tablets today. What do you ask before you reach for the prescription pad?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Depression protocol · Low mood pathway · Self-harm and suicide risk

Sources: NICE NG222 (2022, updated December 2025) · NICE CG192 (2014, updated 2020) · RCPsych stopping antidepressants guidance · NICE NG12 (updated April 2026). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Generalised anxiety disorder: when the alarm system will not switch off

Tue, 03 Nov 2026 06:04:00 +0000

A 28-year-old has worried about everything for a year, sleeps badly and has tense shoulders and palpitations. Is it anxiety, the thyroid, or both, and why not a benzodiazepine?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Anxiety protocol · Anxiety pathway · Benzodiazepines and Z-drugs

Sources: NICE CG113 (2011, updated 2020) · NG116 (2018) · CG31 (2005). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Bipolar disorder: the high you were never told about

Tue, 03 Nov 2026 06:03:00 +0000

A 31-year-old with recurrent depression mentions a week last year when he barely slept and spent his savings. What changes, and what does the GP own once lithium starts?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Bipolar disorder and lithium protocol · Serious mental illness physical health check · Shared care monitoring

Sources: NICE CG185 (2014, updated 2025) · NICE CG192 (2014, updated 2020) · MHRA valproate (2024–2025) · NPSA lithium (2009). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Insomnia: why the best treatment is not a tablet

Tue, 03 Nov 2026 06:02:00 +0000

A 52-year-old has slept badly for six months and asks for zopiclone. What do you look for first, and what works better than a sleeping tablet?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Insomnia pathway · Benzodiazepines and Z-drugs · Obstructive sleep apnoea protocol

Sources: NICE TA922 · NICE HTG624 · NICE TA77 · NICE NG202 · DVLA · BAP · local formulary and benzodiazepine/Z-drug resources · MHRA SPCs. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Alcohol-use disorders: never tell a dependent drinker to just stop

Tue, 03 Nov 2026 06:01:00 +0000

A 47-year-old with raised liver enzymes admits to a bottle of wine a night and morning shakes, and says he will stop tomorrow. Why is that a dangerous plan?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Alcohol and problem drinking protocol · Abnormal liver function tests pathway · DVLA guide

Sources: NICE CG115 (2011) · NICE CG100 (2010) · NICE PH24 (2010) · NICE QS11 · NICE NG50 (2016) · NICE TA325 (2014) · UK clinical guidelines for alcohol treatment (OHID) · UK CMOs 2016 · DVLA AFTD. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Dementia: rule out delirium, then name the subtype

Tue, 03 Nov 2026 06:00:00 +0000

A daughter brings her 79-year-old father, who keeps getting lost and has started seeing children in the garden. Is this dementia, delirium, or something that changes which drugs are safe?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Dementia protocol · Memory problems pathway · Delirium pathway · Mental capacity and best interests

Sources: NICE NG97 (2018) · NICE CG103 (2010, updated 2023) · NICE NG71 (2017) · MHRA · DVLA (GOV.UK) · Local dementia prescribing resources. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Adult ADHD: not laziness, and not a diagnosis for primary care

Tue, 03 Nov 2026 05:59:00 +0000

A 32-year-old has lost three jobs for missed deadlines and thinks she has ADHD after seeing videos online. What do you assess, who diagnoses it, and what is the GP's role afterwards?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: ADHD protocol · Shared care monitoring · Fit note guide

Sources: NICE NG87 (2018, updated 2019) · DSM-5 · Local shared care · Equality Act 2010. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Menopause and HRT: diagnose it clinically, protect the womb

Tue, 03 Nov 2026 05:58:00 +0000

A 49-year-old with night sweats, broken sleep and periods that have gone erratic asks whether she needs a blood test. Usually not. What she needs is a clear diagnosis and an honest talk about HRT.

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Menopause and HRT protocol · Bleeding on HRT pathway · Irregular periods pathway

Sources: NICE NG23 (2015, updated April 2026) · NICE NG12 (updated April 2026) · BMS unscheduled bleeding guideline (2024, current version September 2026). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Heavy menstrual bleeding: believe the impact, check the blood count

Tue, 03 Nov 2026 05:57:00 +0000

A 38-year-old is double-padding at night and has taken three days off work this month. She has been told for years that heavy periods are just normal. Today, they are treated.

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Heavy menstrual bleeding protocol · Heavy menstrual bleeding pathway · Iron deficiency anaemia protocol

Sources: NICE NG88 (2018, updated July 2026) · NICE NG12 (updated April 2026) · CoSRH UKMEC · BSH/BSG iron deficiency · Local formulary and current SPCs. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Contraception: the method she will keep using, safely

Tue, 03 Nov 2026 05:56:00 +0000

A 36-year-old wants to go back on the combined pill she took in her twenties. She mentions, almost in passing, that her migraines now start with zigzag lines. That one sentence changes everything.

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Contraception protocol · Emergency contraception pathway · Migraine protocol

Sources: UKMEC 2025 · CoSRH clinical guidelines current at review (IUC 2023, amended Jan 2025 · POP 2022, amended Apr 2026 · EC 2017, amended Apr 2026 · Over 40s 2017, amended May 2025) · NICE PH51 (2014) · NICE CG30 (2005, updated 2019) · NICE NG12 (updated April 2026). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Polycystic ovary syndrome: two out of three, and a lifetime of risk

Tue, 03 Nov 2026 05:55:00 +0000

A 24-year-old has three or four periods a year, chin hair she plucks every morning, and a cousin with PCOS. She wants a scan. She may not need one, but she does need a glucose test.

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: PCOS protocol · Irregular periods pathway · Hirsutism pathway

Sources: International evidence-based PCOS guideline 2023 (international) · RCOG Green-top 33 (2014, archived Dec 2024) · NICE NG257 (2026) · NICE PH38 (2012, updated 2017) · NICE NG246 (2025) · UKMEC 2025 · Society for Endocrinology 2025. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Suspected ovarian cancer: the bloating that is not IBS

Tue, 03 Nov 2026 05:54:00 +0000

A 58-year-old has felt bloated most days for two months and gets full after a few mouthfuls. She thinks it is irritable bowel. At her age, a new IBS label is the wrong first move.

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Suspected cancer referrals · Bloating pathway · Abdominal mass pathway

Sources: NICE NG12 (updated April 2026; primary-care ovarian cancer recognition moved from NICE CG122). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Breast lump: a benign feel is not a benign diagnosis

Tue, 03 Nov 2026 05:53:00 +0000

A 34-year-old found a smooth, mobile lump in the shower. It feels exactly like a fibroadenoma. Does that change the referral? No, and here is why.

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Breast cancer protocol · Breast symptoms pathway · Benign breast disorders protocol

Sources: NICE NG12 (updated April 2026) · NICE CG164 (2013, updated 2023) · NICE NG101 (2018, updated April 2025) · MHRA Drug Safety Update · NHS Breast Screening Programme. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Vaginal discharge: thrush, BV, or something you must not miss

Tue, 03 Nov 2026 05:52:00 +0000

A 22-year-old has a new discharge and assumes it is thrush again. She has a new partner and a dull ache low in her pelvis. The ache is the part that matters.

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Vaginal discharge pathway · Pelvic inflammatory disease protocol · Bacterial vaginosis protocol · Chlamydia protocol

Sources: BASHH guidelines · NICE NG253 sepsis · NICE NG12 (updated April 2026) · UKHSA/MHRA · Local antimicrobial guidance. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Subfertility: two people, one plan, and the clock that matters

Tue, 03 Nov 2026 05:51:00 +0000

A 37-year-old and her partner have been trying for eight months. The usual advice is to wait a year. For her, waiting is the harm.

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Infertility protocol · Abnormal semen analysis pathway · Preconception and antenatal booking

Sources: NICE NG257 (2026, replaced CG156) · NICE NG23 (updated April 2026) · NICE NG12 (updated April 2026) · HFEA. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Acne: count the spots, commit to twelve weeks

Tue, 03 Nov 2026 05:50:00 +0000

A 17-year-old has tried three creams in six months, each for a few weeks. Now there are small pitted scars on his cheeks. The problem was never the creams.

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Acne protocol · PCOS protocol · Rosacea protocol

Sources: NICE NG198 (2021, last updated 3 August 2026) · MHRA Drug Safety Updates (June 2013; October 2023; October 2025; 22 January 2026) · Local antimicrobial guidance · SPCs. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Atopic eczema: emollients are the treatment, not the extra

Tue, 03 Nov 2026 05:49:00 +0000

A 4-year-old has eczema that flares every few weeks. His mother is using a small tube of emollient a month and is frightened of steroids. Fix those two things and most of the problem goes away.

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Atopic eczema protocol · Blistering rash pathway · Widespread itch pathway

Sources: NICE CG57 (2007, updated September 2025) · NICE NG190 (2021) · NICE TA534 / TA681 / TA814 / TA986 / TA1077 · MHRA Drug Safety Update (Dec 2018, Sep 2021, Nov 2022, Apr 2023, May 2024) · Local antimicrobial guidance. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Psoriasis: treat the plaques on a clock, and ask about the joints

Tue, 03 Nov 2026 05:48:00 +0000

A 42-year-old wants a stronger cream for the plaques on his elbows. He mentions his finger has been swollen like a sausage for a month. That finger is the urgent part.

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Psoriasis protocol · Psoriatic arthritis protocol · QRISK3 calculator

Sources: NICE CG153 (2012, updated 2017) · NICE QS40 (2013) · NICE NG65 (2017) · NICE TA350 · MHRA Drug Safety Update (Dec 2018, Sep 2020, Sep 2021, Apr 2023) · BAD biologics guideline 2023. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Suspicious skin lesions: score it, never shave it

Tue, 03 Nov 2026 05:47:00 +0000

A 61-year-old's wife has noticed his mole on his back has grown and gone patchy brown and black. He thinks it is nothing. Two minutes with a checklist decides the pathway.

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Skin cancers protocol · Pigmented skin lesions pathway · Actinic keratosis protocol · Suspected cancer referrals

Sources: NICE NG12 (2015, updated April 2026) · NICE NG14 (2015, updated 2022) · NICE NG34 (2016) · BAD BCC (2021) and cSCC (2020). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Cellulitis: one hot leg, a marked edge, and the pain that does not fit

Tue, 03 Nov 2026 05:46:00 +0000

A 67-year-old has a hot, red, swollen left shin and cracked skin between her toes. Her neighbour has two red legs and was given antibiotics last week. Only one of them has cellulitis.

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Cellulitis protocol · Sepsis in adults protocol · Fungal skin infection protocol

Sources: NICE NG141 (2019) · NICE NG253 & NG254 sepsis (2025) · NICE NG184 bites (2020) · NICE NG15 stewardship (2015) · BLS/LSN cellulitis in lymphoedema (2022/23 edition) · Eron classification (Eron 2003; CREST 2005). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Leg ulcers: check the arteries, then compress

Tue, 03 Nov 2026 05:45:00 +0000

A 74-year-old has a weeping wound above her ankle that has been dressed for weeks without a diagnosis. The fix is not a better dressing. It is a Doppler and a bandage.

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Venous leg ulcer protocol · Leg ulcers pathway · Peripheral arterial disease protocol

Sources: NWCSP Lower Limb Recommendations (2020, reviewed 2024) · NICE CG168 Varicose veins (2013) · NICE NG152 Leg ulcer infection (2020) · NICE NG12 (updated April 2026) · SIGN 120 (2010) · EVRA trial (2018). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Sore throat: score it, soothe it, and spot the abscess

Tue, 03 Nov 2026 05:44:00 +0000

A 19-year-old student with two days of a painful throat, a fever and no cough wants antibiotics before her exams. Does she need them, and what would make you send her in today?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Sore throat pathway · Glandular fever protocol · Neck lump pathway · Suspected cancer referrals

Sources: NICE NG84 (2018) · NICE NG12 (updated April 2026) · NICE HTG531 rapid strep A tests. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Acute otitis media: pain relief first, antibiotics by the rules

Tue, 03 Nov 2026 05:43:00 +0000

A 3-year-old pulling at his ear after a cold, with a bulging red eardrum and a mother who was up all night. Does he need amoxicillin, and what must you look for behind the ear?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Otitis media and otitis externa protocol · Glue ear protocol · Fever in children pathway

Sources: NICE NG91 (2018, updated March 2022) · NICE NG233 (2023) · NICE NG98 (2018) · NICE NG143 (2019) · UKHSA/NICE Summary of antimicrobial prescribing guidance (RCGP TARGET, version 1.2, September 2024) · Local antimicrobial guidelines · ENT UK aminoglycoside consensus (2007) · ENT UK necrotising otitis externa guidance (2020) · BSO community management of hearing loss and aural blockage (2023) · MHRA Drug Safety Updates. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Hearing loss and tinnitus: the one ear that cannot wait

Tue, 03 Nov 2026 05:42:00 +0000

A 46-year-old woke up two days ago with her left ear muffled and ringing. She assumes it is wax. If it is not, the clock is already running.

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Hearing loss pathway · Tinnitus pathway · Otitis media and otitis externa protocol

Sources: NICE NG98 (2018) · NICE NG155 (2020) · BSO/ENT UK community management of hearing loss and aural blockage (2023). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

The acute red eye: check the vision before you reach for chloramphenicol

Tue, 03 Nov 2026 05:41:00 +0000

A 28-year-old contact-lens wearer has a red, painful right eye and cannot bear the light. He wants drops from the chemist. Why is this one different from conjunctivitis?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Red eye pathway · Infective conjunctivitis protocol · Uveitis protocol · Glaucoma protocol

Sources: College of Optometrists Clinical Management Guidelines · Royal College of Ophthalmologists emergency eye care guidance · NICE NG81 (glaucoma). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Acute sinusitis: time is the treatment

Tue, 03 Nov 2026 05:40:00 +0000

A 38-year-old with a blocked nose and a throbbing face after a cold, eight days in, asks for antibiotics. The ten-day rule, and the eye signs you must never miss.

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Sinusitis protocol · Nasal congestion pathway · Facial pain pathway

Sources: NICE NG79 (2017) · EPOS 2020 (international) · NICE NG12 (updated April 2026) · NICE TA1134 (2026). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Persistent hoarseness: the voice that has not come back

Tue, 03 Nov 2026 05:39:00 +0000

A 58-year-old smoker has been hoarse for five weeks since a cold. He has tried honey and lozenges. Another course of something, or a look at the voice box?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Hoarseness pathway · Neck lump pathway · Suspected cancer referrals · Smoking cessation protocol

Sources: NICE NG12 (updated April 2026) · NICE NG145 (2019) · NICE NG127. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Fever in under-5s: how the child looks matters more than the number

Tue, 03 Nov 2026 05:38:00 +0000

An 18-month-old with a temperature of 39.4 and a worried dad on a Friday afternoon. How do you decide, in a few minutes, who goes home and who goes to hospital?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Fever in children pathway · Fever and rash in a child pathway · Febrile seizures protocol

Sources: NICE NG143 (2019, updated 2021) · NICE NG240 (2024) · NICE NG224. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Childhood wheeze and asthma: wheezy with colds, or asthma?

Tue, 03 Nov 2026 05:37:00 +0000

A 6-year-old with eczema coughs every night and wheezes in games lessons, and has had three courses of salbutamol this winter. Is this viral wheeze, or asthma, and what kills children in an attack?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Asthma in children protocol · Pre-school wheeze protocol · Wheeze in a child pathway · Acute asthma pathway

Sources: NICE NG245 (2024, joint with BTS and SIGN) · SIGN 158 (2019) acute asthma section · MHRA montelukast safety advice · UKHSA Green Book chapter 19 · local paediatric formulary. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Bronchiolitis: feeding, breathing, and knowing who goes in

Tue, 03 Nov 2026 05:36:00 +0000

A 10-week-old with a cold that has gone to the chest, day three, feeding a bit less. No drug helps, so the whole consultation is about the decision: home or hospital?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Bronchiolitis protocol · Pre-school wheeze protocol · Immunisation schedule

Sources: NICE NG9 (2015, updated 2021) · NICE NG143 (2019, updated 2021) · UKHSA Green Book chapter 27a RSV (June 2026). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Constipation in children: disimpact first, then keep going for months

Tue, 03 Nov 2026 05:35:00 +0000

A 4-year-old with painful stools every five days and soiled pants that her parents think is diarrhoea. The red flags to exclude, and why stopping the laxative too early is the commonest failure.

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Constipation in children protocol · Abdominal pain in children pathway · Faltered growth pathway

Sources: NICE CG99 · Rome IV · Local formulary. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Nocturnal enuresis: no blame, treat the bowel, then alarm or tablet

Tue, 03 Nov 2026 05:34:00 +0000

A 7-year-old wets the bed four nights a week and has a school residential trip in two months. What do you check first, and how do you choose between an alarm and desmopressin?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Nocturnal enuresis protocol · Daytime wetting in children pathway · Constipation in children protocol · Suspected diabetes in children pathway

Sources: NICE CG111 (2010). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Palliative and end-of-life care: planning before the crisis

Tue, 03 Nov 2026 05:33:00 +0000

A daughter rings about her 76-year-old mother with lung cancer spread to the bones, who is sleeping more, eating less and wants to stay at home. What do you put in place this week so that three in the morning goes well?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Palliative pain protocol · Palliative nausea and vomiting · Palliative delirium and agitation

Sources: NICE NG31 (2015) · NICE CG140 (2012, updated 2016) · NICE NG142 (2019). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Tiredness and fatigue: the commonest complaint, done properly

Tue, 03 Nov 2026 05:32:00 +0000

A 34-year-old teacher has been exhausted for four months and wants "every blood test going". How do you find the treatable cause without over-investigating, and when is it ME/CFS?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Tiredness and fatigue pathway · ME/CFS protocol · Iron deficiency anaemia protocol

Sources: NICE NG206 (2021) · NICE NG12 (updated April 2026) · NICE NG145 (2019) · NICE NG222 (2022). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Unintentional weight loss: the symptom you must not reassure away

Tue, 03 Nov 2026 05:31:00 +0000

A 67-year-old ex-smoker has lost six kilograms in six months without trying, and nothing else is wrong. Which pathway does he need, and what if the first tests are normal?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Unintentional weight loss pathway · Suspected cancer referrals

Sources: NICE NG12 (updated April 2026) · NICE CG32 (malnutrition). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Falls in older people: rarely one cause, rarely just bad luck

Tue, 03 Nov 2026 05:30:00 +0000

An 83-year-old has fallen twice in four months and could not get up on her own the second time. What must you exclude today, and what actually prevents the next fall?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Falls pathway · Osteoporosis protocol · Frailty medication review

Sources: NICE NG249 (2025) · NICE NG232 (2023) · NICE CG109 (2010, updated 2014). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Interpreting thyroid tests: read the pattern before you treat

Tue, 03 Nov 2026 05:29:00 +0000

A 58-year-old with tiredness has a TSH of 7.2 and a normal free T4 on one test. Do you start levothyroxine, repeat it, or leave it alone?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Hypothyroidism protocol · Hyperthyroidism protocol · Lab results guide

Sources: NICE NG145 (2019, updated Oct 2023) · BTA. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Obstructive sleep apnoea: the driving advice cannot wait

Tue, 03 Nov 2026 05:28:00 +0000

A 52-year-old lorry driver whose wife says he stops breathing at night, and who nearly fell asleep at a junction last week. What do you say before he leaves the room?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Obstructive sleep apnoea protocol · Snoring and sleep apnoea pathway · Daytime sleepiness pathway · DVLA guide

Sources: NICE NG202 (2021) · NICE TA139 (2008, partly updated by NG202) · DVLA Assessing fitness to drive. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Trigeminal neuralgia: electric shocks from a gentle touch

Tue, 03 Nov 2026 05:27:00 +0000

A 66-year-old has stabbing, electric-shock pains in her cheek every time she brushes her teeth, and she has stopped eating properly. Which drug, which scan, and which warning?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Trigeminal neuralgia protocol · Facial pain pathway · Neuropathic pain protocol

Sources: NICE CG173 (2013, updated 2020) · NICE NG127 · EAN trigeminal neuralgia guideline (2019, international). Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Perinatal mental health: baby blues, depression, or an emergency

Tue, 03 Nov 2026 05:26:00 +0000

Five days after giving birth, a 30-year-old is tearful, but her partner says she has barely slept for three nights and is talking strangely. Which of three conditions is this?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Postnatal depression protocol · Postnatal disorders protocol · Self-harm and suicide risk

Sources: NICE CG192 (2014, updated 2020) · NICE NG222 (2022, updated December 2025) · MBRRACE-UK 2025 · SPS/UKDILAS. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Fungal skin and nail infections: scrape first, treat long enough

Tue, 03 Nov 2026 05:25:00 +0000

A 45-year-old has an itchy groin rash that got worse on a steroid cream, and thick yellow toenails he wants tablets for. Two good reasons to take a sample before prescribing anything.

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Fungal skin infection protocol · Nail disorders protocol · Pityriasis versicolor protocol

Sources: BAD tinea capitis 2014 · BAD onychomycosis 2014 · PCDS tinea · UKHSA Trichophyton indotineae (2025) · Local antimicrobial guideline & formulary · SPCs. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Otitis externa: clean, dry and topical, and the diabetic ear that is not

Tue, 03 Nov 2026 05:24:00 +0000

A 26-year-old swimmer with an itchy, painful, discharging ear, and a 74-year-old with diabetes whose ear pain keeps him awake. Same canal, very different problems.

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Otitis media and otitis externa protocol · Ear discharge pathway · Ear pain pathway

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Croup: grade it, give one dose of dexamethasone, and listen at rest

Tue, 03 Nov 2026 05:23:00 +0000

A 2-year-old with a seal-like bark at 7 in the evening and noisy breathing on her mother’s lap. Is that stridor at rest, and what does it change?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Croup protocol · Cough in children pathway · Wheeze in a child pathway

Sources: NICE NG143 (2019, updated 2021) · Cochrane (Gates 2018) · Dexamethasone oral solution SPC. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Cow’s milk protein allergy: prove it by taking milk away and giving it back

Tue, 03 Nov 2026 05:22:00 +0000

A 3-month-old with eczema, reflux and mucus in her nappies, and a mother who has read about milk allergy online. How do you confirm it, what do you prescribe, and which reactions are emergencies?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Cow’s milk protein allergy protocol · Anaphylaxis protocol · Infant reflux protocol · Unsettled baby pathway

Sources: NICE CG116 · BSACI (2014) · iMAP / MAP (primary-care resource) · Resuscitation Council UK. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.

Chronic pain: when the treatment is not a prescription

Tue, 03 Nov 2026 05:21:00 +0000

A 45-year-old with two years of widespread pain, normal scans and broken sleep asks for something stronger. What does NICE NG193 say to offer instead, and how do you have that conversation?

Presented by Sarah (host) and Adam (GP). Both voices are AI-generated (text-to-speech), reading a script written for Reasoning GP.

On Reasoning GP: Chronic primary pain protocol · Neuropathic pain protocol · Chronic back pain pathway

Sources: NICE NG193 (2021) · NICE CG173 (2013, updated 2020) · NICE NG215 (2022) · NICE NG226 (2022) · NICE NG12 (updated April 2026) · NICE NG234 (spinal metastases and MSCC) · NICE NG59 (low back pain and sciatica) · MHRA Drug Safety Updates. Reviewed Nov 2026.

Education for healthcare professionals. It supports, but never replaces, clinical judgement. Check current NICE guidance, the SPC and your local formulary before acting.